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College of Arts & Sciences
Department of Anthropology

Setting the stage for medieval plague: Pre-black death trends in survival and mortality

Sharon N. DeWitte* Article first published online: 15 JUL 2015 DOI: 10.1002/ajpa.22806 © 2015 Wiley Periodicals, Inc. American Journal of Physical Anthropology Volume 158, Issue 3, pages 441–451, November 2015



The 14th-century Black Death was one of the most devastating epidemics in human history, killing tens of millions of people in a short period of time. It is not clear why mortality rates during the epidemic were so high. One possibility is that the affected human populations were particularly stressed in the 14th century, perhaps as a result of repeated famines in areas such as England. This project examines survival and mortality in two pre-Black Death time periods, 11–12th centuries vs 13th century CE, to determine if demographic conditions were deteriorating before the epidemic occurred.


This study is done using a sample of individuals from several London cemeteries that have been dated, in whole or in part, either to the 11–12th centuries (n = 339) or 13th century (n = 258). Temporal trends in survivorship and mortality are assessed via Kaplan–Meier survival analysis and by modeling time period as a covariate affecting the Gompertz hazard of adult mortality.


The age-at-death distributions from the two pre-Black Death time periods are significantly different, with fewer older adults in 13th century. The results of Kaplan–Meier survival analysis indicate reductions in survival before the Black Death, with significantly lower survival in the 13th century (Mantel Cox p < 0.001). Last, hazard analysis reveals increases in mortality rates before the Black Death.


Together, these results suggest that health in general was declining in the 13th century, and this might have led to high mortality during the Black Death. This highlights the importance of considering human context to understand disease in past and living human populations. Am J Phys Anthropol 158:441–451, 2015. © 2015 Wiley Periodicals, Inc."  --

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